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Leading By Example: How Dharavi tackled covid-19

Leading By Example: How Dharavi tackled covid-19

When the first COVID-19 case in Dharavi was announced, there was widespread trepidation about what would be the fate of the village once gripped by the virus. Dharavi, India largest slum area is home to about 10 lakh dwellers with a population density of over 277,136/km sq. With 12 people living under one roof, it is known to be one of the most densely populated areas in the world.

Mid June, Dharavi reported around 2,000 cases. Given the limited resources and the impossibility of conforming to any social distancing measures, the village was poised for a tough battle. Controlling the spread of infection, in an area where 9-10 people stay in a 10×10 sq. ft. room and 80% population is dependent on community toilets, was seen as almost impossible.

How Did They Fight The Battle?

Within 48 hours from when the first case was reported, the district barricaded the entrance and exit to the slum cluster, carried out disinfection of 425 public toilets, began door-to-door screening, and provided food to people in the first month of the lockdown to slow down the spread of the pandemic.

The strategy employed by officials to contain the virus was based on based on 4Ts- Tracing, tracking, testing and treating. The model relied on preemptive testing and extensive screening to combat the virus.

The focus was primarily on following areas:

Aggressive Testing and Screening
The slum carried out 5 lakh door-to-door screenings and a total of 6.5 lakh people were screened. There were 22 quarantine facilities built and 38,000 homes were quarantined. Further, they identified people using common toilets and quarantined them too. The village also managed to ramp up its healthcare capacity in a short period of time. While there 2-3 fever clinics present in the beginning of April, by mid-June they opened 100 clinics. In the absence of testing kits, doctors decided to use oximetres to check oxygen level among the ones being tested. This helped to weed out asymptomatic carriers of the infection.

Door-To-Door Surveys
A team of 25 doctors roamed for 10 days in major hotspots of Dharavi testing thousands of residents. The mobile clinics drove around through the day with a team of doctors, carrying out door-to-door screening of residents, checking for fever and other symptoms, co-morbidities, and collecting swabs (incase of suspected cases), This helped to stem the virus at its source and prevent further spread. The steps for elaborate screening included door-to-door survey of at least 10,000 houses per ward. Each community volunteer, equipped with a thermal scanner and a pulse oximeter screened about 100 houses.

Institutional Quarantine Centres
Since home quarantine was not an option in Dharavi given the high population density, the slum needed institutional quarantine facilities on scale. These were set up in schools, community halls etc. in timely fashion.

Encouraged Reporting
Initially, people were hesitant to report their symptoms due to social stigma, so the district brought in private practitioners to create an environment of trust for people to come out and start reporting.

Chase The Virus Strategy
This meant tracing the “source” after a person is infected and isolating the source for treatment before it infects others. This was done by aggressive bulk testing of at vulnerable spots such as vegetable mandis, markets, BPOs etc.

Public Private Partnerships
The model also comprised of foraging several public private partnerships with various civil society organizations. For e.g., BMC tied up with local doctors,  Bharatiya Jain Sanghatan, Desh Apnaye Foundation,  who helped out in providing mobile vans, medicines etc., while swab testing, isolation and quarantine facilities were being looked after by BMC.

Centre-State Coordination
The Maharashtra State Government has been closely cooperating with the Centre and local bodies to devise a graded response plan. In addition to directives issued by the state, the Central Government also shared various guidelines, advisories and treatment protocols to strengthen the collective response.

After having succeeded in Dharavi, this model is currently being replicated in Mumbai’s suburbs of Malad, Kandivli, Borivali and Dahisar and other districts. What would be the fate of the village once life resumes to normal is still uncertain, but situation seems to be under control at present. The model has been touted the world over for managing to keep numbers relatively low and saving the village from a catastrophe.

About The Author

Srishti Tiku

Srishti is a graduate in Behavioral Economic Science from University of Warwick, UK, and is passionate about using her knowledge to decipher sustainability challenges through research and analysis. As Economics attempts to explain the processes that shape lives and livelihoods, Srishti finds it fascinating to learn about emerging patterns while wading her way through issues engulfing people, planet and profit. When she is not at desk, she loves to read and watch movies.

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